St Luke Integrative Medical Center Inc

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

ST LUKE INTEGRATIVE MEDICAL CENTER INC

Practice address

415E Church St NW Ste 4
Huntsville, AL 35801-5577

Phone

(256) 801-4536

NPI assigned

May 29, 2019

Last updated

Jul 23, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Yvonne C OrtegaNPI 1831185453

Title

Owner

Phone

(256) 801-4536

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Yvonne C Ortega, MD

  • General Practice Physician
  • Huntsville, AL
  • NPI 1831185453
  Medicare reassignment NPD Authorized official
• Angela Pruitt Durham, N.P.

  • Family Nurse Practitioner
  • Madison, AL
  • NPI 1699862474
  Medicare reassignment NPD
• Elena Mihaela Kruse, CRNP

  • Family Nurse Practitioner
  • Huntsville, AL
  • NPI 1003422742

  Single Specialty

  Medicare reassignment NPD
• Gary K Adams, MD

  • Family Medicine Physician
  • Ocala, FL
  • NPI 1487772802

  AL

  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1559088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595462400000",
    "number": "1184282840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415E CHURCH ST NW STE 4",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358015577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415E CHURCH ST NW STE 4",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358015577",
            "telephone_number": "256-801-4536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST LUKE INTEGRATIVE MEDICAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-29",
        "last_updated": "2020-07-23",
        "certification_date": "2020-07-23",
        "status": "A",
        "authorized_official_last_name": "ORTEGA",
        "authorized_official_first_name": "YVONNE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "256-801-4536"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sandria Janay Squaire
• Christopher Squires, PHARM.D.
• Nyla S Squyres, MD
• Deepak Venkat Sree, MD
• Jayashree Srinivasan, DMD
• St. Jude Clinic at Huntsville Hospital for Women and Children
• Tonya Staats, CRNP
• Christian Stachler, PA-C
• Stacie Scherer LLC (Serenity Counseling of Huntsville)
• Tori Tess Stafford

• Multi-Specialty Clinic/Center in Huntsville, AL
• Providers in Huntsville, AL by specialty
• Multi-Specialty Clinic/Center in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.